This thread is for matters concerning the risks of catching cooties while training.

Yip!CD==================

Downey High wrestler with staph infection diesThe 17-year-old was hospitalized for 20 days. Illness can be spread by skin-to-skin contact, dirty towels.By Mary Engel, Los Angeles Times Staff Writer July 25, 2008 A Downey High School wrestler has died after being hospitalized for 20 days with pneumonia and other complications of a staph infection.

Noah Armendariz, 17, died Sunday at Children's Hospital of Orange County, said his mother, Cynthia Magaña.The infection was caused by methicillin-sensitive Staphylococcus aureus, or MSSA, Magaña said.

Another form of S. aureus, known as MRSA for "methicillin-resistant," tends to get more publicity because it has grown resistant to methicillin and some other antibiotics. But infectious disease specialists say that both forms can be deadly if they move from the skin, where they normally reside, into the bloodstream and organs.

"The key is invasive," said Dr. Adam Hersh, a pediatric infectious disease fellow at UC San Francisco. "Only a small number of staph infections among children and adolescents become invasive, but both MRSA and MSSA can be very serious infections when they do."

Both can be passed by skin-to-skin contact or by sharing dirty towels, making them common among wrestlers, football players and others who play contact sports. Armendariz developed a rash shortly after returning from a wrestling camp at a Lake Arrowhead high school in June, Magaña said. A few days after that, he ran a fever and felt pains in his legs.

But he also had dislocated a shoulder, and the doctors she took him to initially focused on that, she said.

On July 1, he felt chest pains, and Magaña took him to the emergency room at Kaiser Permanente Medical Center in Bellflower.

He was admitted to the intensive care unit and stayed there until he was stable enough to be transferred to Miller Children's Hospital in Long Beach, Magaña said. He was later transferred to the hospital in Orange County.

Public health experts recommend hand-washing, showering, laundering towels and uniforms in hot water and disinfecting gym equipment to prevent transmission. They also recommend keeping an eye on rashes and other bumps, especially if they are accompanied by fevers and chills.

Ringworm is another nasty one. My jujitsu coach mopped the mats everyday which made me feel better. But, I still couldn't get home fast enough to shower! He had gotten staph from another gym in town so he was over cautious. I wouldn't say I'm a hygiene freak, but I'm very aware of mine and others. Many could care less if they are sick, bleeding, unshowered...when they work with you.My experience anyway.

In a training environment, the adoption of infection control/blood borne pathogen protocols as used at a law enforcement training academy. I'd cut and paste their policy and procedures related to the training environment and injuries that occur while training, including exposure to blood.

I bet California POST has a nice program drawn up with your tax dollars worth looking at.

Make sure to keep the mats clean, and wash your clothes. Most importantly, if someone has something (ringworm or anything else) KEEP THEM OFF THE MAT. I don't know how many times I've seen guys tape over ringworm and want to continue to train. Nobody likes to miss out on training, but you need to make sure you don't contaminate your whole gym.

Personally, I scrub my body with anti-fungal shampoo after I train. Maybe I'm just paranoid.

Make sure to keep the mats clean, and wash your clothes. Most importantly, if someone has something (ringworm or anything else) KEEP THEM OFF THE MAT. I don't know how many times I've seen guys tape over ringworm and want to continue to train. Nobody likes to miss out on training, but you need to make sure you don't contaminate your whole gym.

Personally, I scrub my body with anti-fungal shampoo after I train. Maybe I'm just paranoid.

Damn dude, people tape over ringworm and just keep going? WTF is wrong with them? Has someone talked some sense into these people?

We have the stinky guys in our gym. I think it happens everywhere. I wonder sometimes how you can be lazy enough to skip washing your gear, but have the motivation to come and train regularly? I guess it is one of lifes little mysteries?

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When life gives you lemons make lemonadeWhen life gives you hemlock, do NOT make hemlockade!

Many moons ago when I coached in high school, we used some intense antibacterial cleaning agent that was commercially available for wrestling mats. We washed the mats before and after practice every day. We also stringently followed the guidelines about showering and washing and getting the kids to bring fresh clothing and not share equipment.

Regarding the transmission of HIV and other bloodborn illnesses, I have used hand guards that are the old fashioned white pads with a thumb hole. Apparently these are cheap, washable, and prevent splatter. They don't do much to pad impact.

Have you considered asking fighters at gatherings to get tested for HIV/other things prior to the Gatherings?

Frequent and good hand washing. Keep skin intact. Cover any thats not.Most of these diseases, if not all of them need a "portal of entry" TG

Amen. I am inside prisons regularly and put on antibiotic ointment and cover any hand/arm wounds before I go in. I also don't touch my face (or genitals) until I wash my hands.

A bleach/water solution of 1:10 (3/4 cup bleach in 1 gallon of water) is supposed to kill MRSA (and pretty much everything else) but it should be made daily if it's in an open bucket. You can put it in a spray bottle for smaller areas. Also, anything introduced after the bleach/water mixture has dried will be viable - in other words, bleach is useless after it dries - so you should clean daily at least.

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I don't know how many of them it would have taken to whip my ass, but I knew how many they were going to use. That's a handy little piece of information.- Ron White

Make sure to keep the mats clean, and wash your clothes. Most importantly, if someone has something (ringworm or anything else) KEEP THEM OFF THE MAT. I don't know how many times I've seen guys tape over ringworm and want to continue to train. Nobody likes to miss out on training, but you need to make sure you don't contaminate your whole gym.

Personally, I scrub my body with anti-fungal shampoo after I train. Maybe I'm just paranoid.

Damn dude, people tape over ringworm and just keep going? WTF is wrong with them? Has someone talked some sense into these people?

We have the stinky guys in our gym. I think it happens everywhere. I wonder sometimes how you can be lazy enough to skip washing your gear, but have the motivation to come and train regularly? I guess it is one of lifes little mysteries?

I actively call out our stinky dudes for the health of the gym. I tell them to go take a shower and wash their clothes/gear before I work with them. I won't spar or roll with anyone that stinks. I might be a pansy to some, but then again, I don't have any skin diseases.

Good point here from Dog Ryan-- which is the matter of speaking up. In the deeper sense of things, its a matter of self-defense and asserting your space.

Sometimes we may hesitate for fear of giving offense. Apart from clarity of what is at stake and a sense that I am worth defending, I like to use humor. Indeed my use of the word "cooties" from my boyhood is part of my technique. Instead of "Hey man, is that some Herpes you got going there?" sometimes it plays lighter to say "I dunno man, you're looking a tad cootied there".

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by Lois Pilant

For many officers the greatest fear is not some punk's bullet, it's the business end of a junkie's dirty needle.

You might think that getting stuck by a needle in the course of a shift would be the least of an officer's worries, especially when there are so many other things to worry about: like how fast a traffic stop can go bad; the irrational behavior of the players in a domestic violence call; the stupidity of the guy who flees the police and the risks inherent in a chase.

But talk to Officer Don Gause, an eight-year veteran of the Myrtle Beach, S.C. Police Department, and he'll tell you that a needle stick or accidental exposure to HIV, hepatitis, or any other bloodborne pathogen is absolutely his greatest fear.

"On a traffic stop, you know the potential is there to be shot. On a domestic violence call, you know how fast a complainant can become a defendant. But to be stuck by a needle on a pat down, that's something else. If you get shot, you know right away if you're going to be all right or not. With a needle stick, you won''t know for six months. That's scary."

How scary? Just ask Cpl. Darryl Bolke, a 14-year veteran of the Ontario, Calif. Police Department. He says getting stuck by a needle "ranks right up there with the worst thing I''ve had to go through in my life."

Bolke was stuck on the index finger while searching a man he''d arrested for solicitation of a prostitute. Although he asked if the man had any sharp objects in his pocket, and although he noticed an object on the initial pat down, the object didn''t feel like a syringe. It felt, he said, like a crack pipe. Bolke put his hand in the man''s pocket and was immediately jabbed by a needle sticking out of a small, 2-inch piece of plastic that had been fashioned into a homemade syringe. What made Bolke''s situation worse was that it happened 10 years ago, when there was less information about HIV and other bloodborne diseases, when there were no prophylactic drugs given post exposure, and when getting a blood sample from the source meant fighting your way through a battery of privacy laws, the courts, and the medical community.

"I had no intimate contact with anyone in my family for three months following the first blood test. The crook was treated like the victim by the courts and the medical community, and I had no rights at all. I felt like I'd been victimized twice," Bolke says.

Times have changed. Today''s officers are offered immunization with drugs like GlaxoSmithKline''s Twinrix for Hepatitis A and B; education in the prevention of and protection from exposure to bloodborne pathogens and tuberculosis; personal protective equipment; training in search techniques that use a baton or the blade of the hand; and post-exposure counseling and medical care. In addition, there are now laws that require the source to provide a blood sample on request or through a court order. Finally, today''s officers have available an abundance of reassuring statistics that detail exposure rates and the rarity of exposure converting to a disease.

High Frequency, High Risk

Such precautions have not dispelled many officers' continuing fears of exposure to HIV, hepatitis, or tuberculosis. One reason is that in the context of risk management, exposure comes from job duties that are considered high frequency: arrests and physical searches; vehicle searches; blood and body fluids at accidents and crime scenes, just to name a few. Because exposure and subsequent conversion can be fatal, these activities are also considered high risk.

Added to this deadly mix is the fact that an officer probably will, during the course of a shift, come into contact with an infected person.

In 1996, an estimated 98,000 to 145,000 HIV-positive inmates were released from prisons and jails. Also in 1996, between 1.3 million and 1.4 million inmates released from prison or jail were infected with hepatitis C. That same year, approximately 155,000 released prisoners had current or chronic hepatitis B, while 566,000 were released with latent TB infection. In addition, between 12 and 35 percent of the total number of people in the United States with some sort of communicable diseases passed through a correctional facility.

And the one thing many of these disease carriers have in common is further contact with police. According to a report from the Bureau of Justice Statistics, 67 percent of the nearly 300,000 people released (from 15 test states) in 1994 were rearrested for a new offense, almost exclusively a felony or serious misdemeanor. They had accumulated 4.1 million arrest charges prior to their most recent imprisonment and another 744,000 charges within three years of their release (an average of four new crimes each).

Given these figures, it doesn''t take a rocket scientist to calculate that the inordinate number of infected releasees and the high rate of recidivism almost guarantees contact between an infected person and a police officer. Those numbers do not include contact with illegal aliens and the homeless, who often spend time in crowded, unventilated shelters that can be breeding grounds for diseases like tuberculosis and bacterial meningitis. It also doesn't include the drug addicted, a group that typically has little concern for health care or personal cleanliness, and even less concern for those who arrest them.

Lying in Wait

For years, the scariest of infectious diseases was HIV. Today's nemesis, however, is hepatitis C (hep C), a virus that is spread by contact with the blood of an infected person and eventually causes liver disease. While health officials estimate that about 1 million people in the United States are HIV infected, about 3 million to 4 million Americans are infected with hep C.

At least 75 percent of the people infected with hep C don''t even know it, according to Debbie Borst, a registered nurse who does in-service health care training for South Carolina police agencies. Those numbers held true in a recent statewide study that required a hep C test for tattoo artists renewing their licenses. The study revealed that more than 60 percent of those tested were infected with hep C and completely unaware.

"I call it the stealth virus," Borst says. "It can lie dormant for five to 20 years, and while it''s doing that it''s eating the liver cells. You may have some flu-like symptoms in the beginning, but when those go away, you are generally symptom free. Then one day you wake up with jaundiced skin, orange urine, and yellow eyeballs, or you may have liver cancer."

Hepatitis C was a stealth virus for health care professionals as well. The disease has been around for 50 years, since its first transmission was documented through blood transfusions during World War II. But the virus was only clinically identified in the late ''80s when technology finally caught up with it.

Several factors make hep C a deadlier adversary than HIV. For example, HIV cannot live outside the body, whereas the hep C virus can live outside the body for up to seven days. One drop of HIV-positive blood contains about eight live viral particles, while one drop of hep C-infected blood contains about 100, making transmission of the virus that much more likely.

Hepatitis A and B are equally virulent, but less likely to be transmitted. Although both can live for longer periods outside the body, public safety and health care employers are now required to offer immunization against hepatitis B. Hepatitis A, the oldest form of the virus, is spread by ingesting contaminated food or water. Although police officers are certainly not immune, their chances of exposure to hep A or hep B are smaller than those with hep C and HIV.

Tuberculosis and bacterial meningitis also have been pinpointed as problems for law enforcement officers. These are airborne diseases that are transmitted by breathing or coughing on someone. Among law enforcement officers, the most susceptible to these diseases are those who work in prisons and jails, since transmission generally requires that the bacterial count build to a certain level before infection.

According to Laura Herring, the occupational infectious disease nurse for the city of Portland, it would take longer than a ride to the stationhouse for someone to become infected with TB or bacterial meningitis. "The people who might be vulnerable would be those who have to have face-to-face interaction with an infected individual over a period of several hours," she says.

Fear vs. Reality

Which brings us to the real question: Exactly how vulnerable are you as police officers to contracting disease from a needle stick, a blood splash, or convict spit?

"The most important thing is to keep it in perspective," Herring says. "The way to do that is to be sure you have all the information about the diseases, how they are transmitted, and the rate of conversion or the likelihood of actually contracting the disease after exposure."

Conversion rates are actually strikingly low. According to the Centers for Disease Control, those exposed to HIV have a 0.3 percent chance (1 in 300) of becoming HIV positive. The risk after exposure from contact to the eye, nose, or mouth is approximately 0.1 percent, or 1 in 1,000. The risk after exposure of the skin to HIV-infected blood is estimated to be less than 0.1 percent. And a small amount of blood on intact skin probably poses no risk at all. In fact, there has been no documented case of HIV transmission due to an exposure involving a small amount of blood on intact skin. The risk may be higher if the skin is damaged-for example, by a recent cut-or if the contact involves a large area of skin or is prolonged (for example, being covered in blood for hours).

The risk of conversion to hepatitis is slightly higher. Those who received hepatitis B vaccine and developed immunity to the virus are at virtually no risk for infection. For the unvaccinated person, the risk from a single needle stick or a cut exposure to hep B-infected blood ranges from 6 to 30 percent, and depends on the level of the virus and its antigens in the source''s blood. Of those exposed to hep C from a needle stick or cut, the risk of infection is approximately 1.8 percent. The risk following a blood splash is unknown, but is believed to be very small.

But just because the conversion rates are low does not mean you shouldn''t be cautious. Diseases like HIV, AIDS, and hepatitis are deadly and therefore should engender a certain amount of fear. "Fear is good. It keeps you alive," one officer said. "Panic is bad because you''ll blow it."

"I know I have to be careful," adds Officer Skip Chatford, a patrol officer with the Corona (Calif.) Police Department. "But I don't worry about it every day. When I do a search, I don''t stick my hands in people''s pockets if I can help it. I pull at the top of the pocket and roll the liner out. I just keep rolling until the stuff inside comes out. If I know I''m going to a stabbing or a shooting, I stop and put on gloves before I get there. I stop and think before I do anything. I try to stay aware of what is happening and not rush in without thinking. I feel like I have the education and the equipment I need to protect myself. That''s what has dispelled any initial fear I may have."

Lois Pilant is the former editor of a law enforcement magazine, a writer for the National Institute of Justice, and a frequent contributor to POLICE.

A Food and Drug Administration advisory panel this week will consider three proposed antibiotics designed to treat serious skin infections, including some caused by a type of staph bacterium resistant to many antibiotics.

The bacterium -- methicillin-resistant staph aureus, or MRSA -- has sparked concern as the super bug has moved into community settings like schools and locker rooms in recent years after once being largely confined to hospital settings. But it's not clear if any of the three drugs will reach the bar for FDA approval because of safety concerns or questions about how well the drugs work compared with other available medications.

On Wednesday the panel is expected to vote on Theravance Inc.'s telavancin and Targanta Therapeutics Corp.'s oritavancin before considering iclaprim by Swiss biotech company Arpida Ltd. Thursday.

The FDA posted a review Monday of telavancin and oritavancin ahead of the meeting. Iclaprim's review is expected Tuesday.

Telavancin has already faced trouble gaining FDA approval. Last year, the agency refused to approve the drug and asked for additional clinical data. Earlier this year, the agency canceled an advisory panel meeting for telavancin after it had discovered violations of good clinical practice at some study sites involved in telavancin's clinical trials.

On Monday, the FDA said that, after tossing data from five sites out of about 200 study sites, the rest of the study information used to evaluate telavancin was "reliable," thereby allowing the agency to consider it as part of the drug application submitted by Theravance.

Overall, the agency said both telavancin and oritavancin met study goals of being at least as good as a vancomycin -- an older, generic antibiotic -- at treating skin infections.

However, the FDA said it was concerned about an "imbalance" in the number of serious adverse events that involved the kidneys, with more patients receiving Theravance's telavancin having some problems when compared with those receiving vancomycin.

The agency also said it would ask the FDA panel for advice about whether a risk-management program would be needed to keep pregnant women from receiving the drug because of concerns about the drug's effect on a developing fetus, based on results from animal studies. The agency also noted that 18 patients receiving telavancin or vancomycin died during studies and said some deaths in both groups were possibly drug-related.

Theravance said in a statement that "the safety profile of telavancin in these studies was compatible with treatment of patients with serious infections."

In a review of Targanta's oritavancin, the FDA looked at the impact of the drug on 11 types of bacteria -- including MRSA -- compared with vancomycin's effects. The agency said one of the studies showed that a lower percentage of oritavancin patients were considered a treatment success for MRSA, and it will ask the panel to comment on that finding.

Targanta, in briefing documents posted on FDA's Web site, said oritavancin was "safe and well-tolerated."

--------------------------------------------------------------------------------Know the Truth about MRSA Skin Infections The truth about methicillin-resistant Staphylococcus aureus (MRSA) may surprise you, according to Centers for Disease Control and Prevention (CDC). MRSA is a type of staph bacteria that causes skin and other kinds of infections. Sometimes called “the superbug,” MRSA is resistant to certain antibiotics, but several antibiotics still work. And many times, antibiotics aren’t even needed—doctors are often able to treat MRSA skin infections by simply draining them. Because skin infections caused by MRSA are increasing, the CDC launched a new campaign to educate families about MRSA and provide a four-step process for helping prevent infections.

Although most of these skin infections are mild, some infections may become life-threatening. According to the CDC, there are a few simple steps you can take to protect yourself and your family from MRSA skin infections.

Step 1: Know the signs and symptoms of MRSA and get treatment earlyA staph skin infection, including one caused by MRSA, usually appears as a bump or infected area on the skin that may be red, swollen, painful, warm to the touch, or full of pus or other drainage. It is especially important to contact your health care provider if these signs and symptoms are accompanied by a fever.

Step 2: Keep cuts and scrapes clean and coveredKeeping cuts and scrapes covered will help prevent spreading bacteria to others. If you think the area is infected, contact your healthcare provider and follow his or her instructions about proper care of the infection. Be sure to discard used bandages in the trash.

Step 3: Encourage good hygiene such as cleaning hands regularly Bacteria and other germs are often spread from person to person by direct contact—mostly by our hands. Clean your hands frequently with soap and water or an alcohol-based hand rub, especially after changing a bandage or touching infected skin.

Step 4: Discourage sharing of personal items such as towels and razors Avoid sharing personal items such as towels, washcloths, razors, or clothing that may have had contact with infected skin or soiled bandages. Wash sheets, towels, and clothes with water and laundry detergent. Water temperatures for household laundry depend on the type of fiber or fabric of the clothing. In general, wash and dry in the warmest temperatures recommended on the clothing label. Use a clothes dryer to dry clothes completely.

So about 6 months ago, I had an interesting run in. Having spent a lot of time barefoot, my feet had developed a bit of a tendency for the skin to crack at the heel. Generally I have pretty much ignored this despite the fact that the cracks occasionally get deep enough to cause pain.

I was working out at the Y and as near as I can tell picked up a staph infection through the crack. I presume from the locker room. It was troubling me a bit so I tried to clean up the area with lots of soap and water and kind of working the area with my fingers to remove some of the dried skin. As a result I contracted an infection of the epidermis, known as "cellulitis". The infection had no bump or obvious focal point but instead looked like a deep, red skin rash. In 8 hours it moved from my ankle to the middle of my hamstrings and covered the entire back of my leg.

It took me almost a month of IV antibiotics followed by oral antibiotics to get this under control. It was not MRSA. It was a regular staph infection. It was still pretty dangerous.

My lessons learned:

Cellulitis can kill you if it is not untreated.

Take care of my feet. Rather than letting my heels get so bad that cracks form I now manage the area by abrading calluses down. Your feet do not have to have lots of callus to be tough.

Avoid contact with obviously dirty places like locker room floors. (I won't go into details about what old codger YMCA clients do on locker room and shower floors!)

I have also started wearing a funky kind of shoe made by Vibram called Fivefingers. These things are a kind of sock with toes that is reinforced by a vibram sole. http://www.vibramfivefingers.com/

I saw these on the Crossfit site and then again on a site dedicated to barefoot long distance running. They are comfortable, have really good traction ( almost too good if you need to spin on your foot), and are an amazing conversation starter!

I also am somewhat paranoid about following the CDC general guidelines. I wash my hands a lot and cover open wounds when before I might have ignored it.

My school makes it a point to mop the mats every day with a hydrogen peroxide solution designed for cleaning mats, and we spray our kicking shields, thai pads etc with lysol. We've been around a long time (20 years) and we've had just one instance of staph. It wasn't anything major, but my sifu brought those of us who clean the mats and such and showed us a whole bunch of pictures of what bad staph and ringworm can develop into, to make sure everyone was familiar with the beast. I used to teach a chin na class, and from time to time I would mention hygenic issues while training- not just being clean, but making sure they cut their dang nails- it sucks when you get scratched open because someone has uncut nails that surely have a lot of cooties growing on the undersides.

The research that we have been briefed on in the hospital setting reports that Community acquired MRSA is actually a slightly different strain that the hospital Born or (nosicomial) versions of the past. so what? well the two may respond differently to the same antibiotic. Also The most proven way to avoid a staff infection is Hygiene!!! Prevention of MRSA is the most efficient way to treat it. in fact it has become a Superbug do to the fact it has been exposed to a large variety of increasingly powerful antibiotics.

Maybe it should just plain be a Gym policy to only come workout with clean gear and encourage good hygiene. Often times simply reminding people that there is an increased prevalence of these superbugs is enough to get people to be more conscientious if for no other reason than to protect themselves.

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I am here to chew bubble gum and kick some ass and I'm all out of bubblegum

I just woke up from almost 14 straight hours of sleep. What ever I have I wouldn't wish on my worst enemy. Likely just the flu I was on the brink of tears from a migraine that was coming on. Luckily I was able to catch it in time and the pain has subsided. Working with the public has it's benifits but catching all of the gross viruses out there is definitely one of the immense downfalls.

With exposure to anything Consider dosage- smaller the dosage the less dangerduration- shorter the hazard is in contact with you the less the damageroute of entry- inhalation, ingestion, absorbtion, injection

My policy-Keep your gear clean...attempt to wash all training clothes. Wear 1x, then wash. 2x max. Air clothes out after practice so they dry. Use a dryer for a minimum of 5-10minutes at high heat. Oxyclean or baking soda to get smells out. Hot water.